Encyclopedia of

Vasectomy

Definition

A vasectomy is a surgical procedure performed on adult males in which the
vasa deferentia (tubes that carry sperm from the testicles to the seminal
vesicles) are cut, tied, cauterized (burned or seared), or otherwise
interrupted. The semen no longer contains sperm after the tubes are cut,
so conception cannot occur. The testicles continue to produce sperm, but
they die and are absorbed by the body.

Purpose

The purpose of the vasectomy is to provide reliable contraception.
Research indicates that the level of effectiveness is 99.6%. Vasectomy is
the most reliable method of contraception and has fewer complications and
a faster recovery time than female sterilization methods.

The cost of a vasectomy ranges between $400 and $550 in most parts of the
United States. Some insurance plans will cover the cost of the procedure.

Demographics

Approximately 500,000 vasectomies are performed annually in the United
States. About one out of every six men over the age of 35 has had a
vasectomy. Higher vasectomy rates are associated with higher levels of
education and income.

Description

Vasectomies are often performed in the doctor's office or an
outpatient clinic using local anesthesia. The area around the
patient's scrotum (the sac containing the testicles that produce
sperm) will be shaved and cleaned with an antiseptic solution to reduce
the chance of infection. A small incision is made into the scrotum. Each
of the vasa deferentia (one from each testicle) is tied in two places with
nonabsorbable (permanent) sutures and the tube is severed between the
ties. The ends may be cauterized (burned or seared) to decrease the chance
that they will leak or grow back together.

"No scalpel" vasectomies are gaining in popularity. Instead
of an incision, a small puncture is made into the

In a vasectomy, an incision is made in the man's scrotum. The
spermatic cord is pulled out (B) and incised to expose the vas
deferens, which is then severed (C). The ends may be cauterized or
tied off (D). After the procedure is repeated on the opposite cord,
the scrotal incision is closed (E).
(

Illustration by GGS Inc.

)

scrotum. The vasa deferentia are cut and sealed in a manner similar to
that described above. No stitches are necessary and the patient has less
pain. Other advantages include less damage to the tissues, less bleeding,
less risk of infection, and less discomfort after the procedure. The
no-scalpel method has been used in the United States since 1990; as of
2003, about 30% of vasectomies are performed with this technique.

The patient is not sterile immediately after the procedure is finished.
Men must use other methods of contraception until two consecutive semen
analyses confirm that there are no sperm present in the ejaculate. It
takes about four to six weeks or 15–20 ejaculations to clear all of
the sperm from the tubes.

In some cases vasectomies may be reversed by a procedure known as a
vasovasostomy
. In this procedure,
the surgeon reconnects the ends of the severed vasa deferentia. A
vasectomy should be considered permanent, however, as there is no
guarantee of successful reversal. Vasovasostomies are successful in
approximately 40–50% of men.

Diagnosis/Preparation

No special physical preparation is required for a vasectomy. The physician
will first assess the patient's general health in order to identify
any potential problems that could occur. The doctor will then explain the
possible risks and side effects of the procedure. The patient is asked to
sign a consent form which indicates that he understands the information he
has received, and gives the doctor permission to perform the operation.

Aftercare

Following the surgery, ice packs are often applied to scrotum to decrease
pain and swelling. A dressing (or athletic supporter) which supports the
scrotum can also reduce pain. Mild over-the-counter pain medication such
as
aspirin
or
acetaminophen
(Tylenol) should be able to control any discomfort. Activities may be
restricted for one to two days, and sexual intercourse for three to four
days.

Risks

There are very few risks associated with vasectomy other than infection,
bruising, epididymitis (inflammation of the tube that carries the sperm
from the testicle to the penis), and sperm granulomas (collections of
fluid that leaks from a poorly sealed or tied vas deferens). These
complications are easily treated if they do occur. Patients do not
experience difficulty achieving an erection, maintaining an erection, or
ejaculating. There is no decrease in the production of the male hormone
(testosterone), and the patient's sex drive and ability are not
altered. Vasectomy is safer and less expensive than
tubal ligation
(sterilization of a female by cutting the Fallopian tubes to prevent
conception).

According to both the World Health Organization (WHO) and the National
Institutes of Health (NIH), there is no evidence that a vasectomy will
increase a man's long-term risk of testicular cancer, prostate
cancer, or heart disease.

Normal results

Vasectomies are 99% successful in preventing conception. As such, male
sterilization is one of the most effective methods of contraception
available to consumers.

Morbidity and mortality rates

Complications occur in approximately 5% of vasectomies. The rates of
incidence of some of the more common complications are:

mild bleeding into the scrotum: one in 400

major bleeding into the scrotum: one in 1000

infection: one in 100

epididymitis: one in 100

sperm granuloma: one in 500

persistent pain: one in 1,000

Fournier gangrene is a very rare but possible complication of vasectomy in
which the lining of tissue underneath the skin of the scrotum becomes
infected (a condition called fasciitis). Fournier gangrene progresses very
rapidly and is treated with aggressive antibiotic therapy and surgery to
remove necrotic (dead) tissue. Despite treatment, a mortality rate of 45%
has been reported for this condition.

Alternatives

There are numerous options available to couples who are interested in
preventing pregnancy. The most common methods are female sterilization,
oral contraceptives, and the male condom. Female sterilization has a
success rate of 99.5%; oral contraceptives, 95–99.5%; and the male
condom, 86–97%.

WHO PERFORMS THE PROCEDURE AND WHERE IS IT PERFORMED?

Vasectomy is a minor procedure that can be performed in a clinic or
doctor's office on an outpatient basis. The procedure is generally
performed by a urologist, who is a medical doctor who has completed
specialized training in the diagnosis and treatment of diseases of the
urinary tract and genital organs.

QUESTIONS TO ASK THE DOCTOR

How often do you perform vasectomies?

What is your rate of complications?

How long will the procedure take?

What will the procedure cost? Will my insurance cover the cost?

Do you perform vasectomy reversal? What is your success rate?

User Contributions:

Twenty years ago after my wife delivered 3rd child I was thinking to do vasectomy because I thought i may not need any more children, but twenty years after i have second wife and she need a child after she mention it i was thinking to ask an advice with a Doctor. Well i did it and the Doctor said if PVC pipe can joint why not vasectomy repair. Doctor you think i can get a child ?

Pls tell me if there is any long term pain associated with vasectomy and if there is any lump sort of forming at the region where the vas deferens are cut. also does it affect the quantity, quality and colour of fluid u ejaculate? is vasectomy common among urologists in mumbai - India and how much does it cost here? Thank u so much..

I would like to know how much it would cost to have a reversal done? My fiance and I met 3 years ago, he has 3 children and I have 2 but there is always the thought of having more. If we were to do a reversal vasectomy, what are the chances fertiliztion? Thank you so much for your time.

My husband just had a vasectomy last week. I heard somewhere that after the procedure, he should not lift anything heavier than 5 lbs for at least 3 weeks. I am not sure how reliable this information is and, since we have a 1-year-old daughter, it is hard to avoid lifting her at least. Does he really have to not lift anything for 3 weeks?

my husband has done vasectomy 3 years ago , if we want child , can his vasectomy repair ? how many % chances that we can get a child ? how long we have to wait for the result after the procedures ? we want more child.

I have have had a vasectomy performed in Germany by a German doctor when I was there in the Service with the US Army. The procedure was performed because they said it was too and dangerous for my wife then to have a tubal ligation, as she had medical complications. But she could not be allowed to get pregnant anymore. So, I went along with it and they placed silver clips at the ends of my vasa deferentia at both sides. That was in 1976. That area has always been tender ever since I had this done in Germany. I am now 70 years of age. Lately I have been having severe pain in my left scrotum and it has also been swelling at times. It is hard to wear slacks anymore as that area is tender to the touch and can not place and pressure from my trousers there even when I walk. I went to my Urologist and they sent me to do an ultra sound test and they said everything was normal. I had no fluid building up or leaking nor blood or anything they could find. I told the doctor I had trouble getting an erection, and that i wanted the clips to be removed. He said that it was not a good idea, so he gave me a pump to try out. I tried the vacuum pump, and it pulled my testicle (left one) into the tube and caused me more pain. It keeps drawing my testicle into the tube and I can not use the pump for that reason. I need to find a doctor that can just take the darn clips out. Do you know of any doctor in Orlando, or near Orlando, FL that can perform such a surgery As soon as possible? PLEASE DO NOT POST THIS NAME AND ADDRESS ON ANY INTERNET SITE. THANK YOU. Mr. IAM.

Two years ago i had the procedure done and the doctor that did it said that only my left side needed to be done, because of the fact that i only have one kidney on my left side. Is this true? If not, and only one did was done, i'm i then still able to produce sperm from the left tube? I would really like to know if that the case...in a new relationship and she wants to have a baby. Thank You so much, looking to hear from you soon.

my boyfrend severed vasectomy in 2008 ...n got devorsed same year, i met him a yar a go we met can it be reverse, a what percentage may it work? are there side effect,and where can we go for that procedure? thank you

I would like to know that some answers the follwing,
I have no children in past 4 years
and my problem was sperm route tube is nil
any chance to tube fittment in artificial?
because I am try two times for ICSI treatment and no result in each time

Hello! I'm 36 years old and had a vasectomy one year ago and have been experiencing pain on the lower right side of my abdomen area when I go hard during sex or if my wife is on top, but never had this issue before the vasectomy. Also I have had 2 prostate infections and the treament has been Trimethoprin but this second infection that i currently have had been bothering me for going on 2 weeks now despite the Trimethoprin. So i called the urologist and was told to take a 15 day dose of Cipro 500mg 2x a day. After reading the side effects im afraid of taking it and i feel like maybe i could be prescribe something less strong but yet strong enough to clear the infection. It's been horrible having burning urination\ejaculation, and having blood present. Fortunately i've not had back
pains or a fever.
What should I do also im really concerned about Fournier gangrene, can it develop over a year later ?